At least three women were infected with H.I.V. during cosmetic “vampire facial” procedures at an unlicensed spa in Albuquerque, federal officials said Thursday. It is the first time that H.I.V. transmission through cosmetic injection services has been documented, they said.
The three were among a cluster of five people sharing highly similar H.I.V. strains, four of whom had undergone a procedure called platelet-rich plasma microneedling at the spa. The fifth individual, a man, had a sexual relationship with one of the women.
Investigators still do not know the precise source of the contamination. A 2018 H.I.V. diagnosis in a patron who reported having no behavioral risk factors led to a public health investigation when the woman said she had received a cosmetic treatment involving needles, called a platelet-rich plasma microneedling facial.
An inspection of the spa found unlabeled tubes of blood lying on a kitchen counter, others stored along with food in a refrigerator, and unwrapped syringes in drawers and trash cans.
The facility also appeared to be reusing disposable equipment intended for single use only, according to a report from the Centers for Disease Control and Prevention.
The report comes on the heels of an announcement by health officials earlier this month that they are investigating a string of illnesses tied to counterfeit or improperly injected Botox containing high amounts of the botulinum toxin, which is used in small doses to smooth wrinkles.
“If people are concerned — and I’ve had friends ask me, ‘What would you do?’— the first step is to check that your provider is licensed to provide cosmetic injection services,” said Anna M. Stadelman-Behar, an epidemiologist with the C.D.C. who is the lead author of the H.I.V. report.
“If they’re licensed, then they have had infection-control training and know the correct procedures, and are bound by law to follow proper infection-control practices.”
Overall, she noted, the risk of infection during cosmetic procedures is generally low. “If you have any concern, go and get an H.I.V. test,” Dr. Stadelman-Behar said. “The C.D.C. recommends all adults between 13 and 64 get tested at least once as part of routine medical care and know their status.”
The so-called vampire facials involve drawing a patient’s own blood, putting it in a centrifuge to separate out platelet-rich plasma, and then using very fine, short needles to puncture the skin.
This is said to prompt the skin to produce elastic and collagen, and to create openings for the plasma, which is applied topically to help with skin repair. The procedure is promoted for reducing signs of aging, acne scarring and sun damage.
The New Mexico Department of Health, which was notified of the unusual H.I.V. infection in 2018 when the first woman was diagnosed, opened an investigation of the spa. Over time officials identified four former clients and a sexual partner who had received H.I.V. diagnoses between 2018 and 2023, despite reporting few risks associated with infection, such as injection drug use, blood transfusion or sexual contact with a new partner.
The spa closed in the fall of 2018, shortly after the identification of the first unusual infection. But the investigation, as well as attempts to notify clients and former clients that they may have been exposed to H.I.V., was hampered by the spa’s poor records.
Eventually, investigators managed to put together a list of names and phone numbers from consent forms that clients had signed, handwritten appointment records and phone contacts. They identified 59 clients who were at risk for infection, including 20 who received “vampire facials” and 39 who got other services, like Botox, between the spring and fall of 2018.
Public health investigators also reached out to the community about the risks to former clients of the spa. Overall, 198 former spa clients and their sexual partners were tested for H.I.V. between 2018 and 2023.
Five people carrying viruses that were highly similar were confirmed to have spa-related cases. But two of them — a woman who had been a client and her male partner — had advanced H.I.V. disease that investigators said most likely resulted from earlier infections, prior to their spa treatments.
The report said that two individuals in the cluster had tested positive during rapid H.I.V. tests done when they applied for life insurance, including one who was tested in 2016, before receiving treatment at the spa, and one in the fall of 2018.
Only one had been notified of the positive test result, however, and had the diagnosis confirmed by a primary care provider in 2019.
Investigators said they never identified the exact route of contamination at the spa during the spring and summer of 2018.
“When we did the inspection at the spa, it was clear that needles were being reused, and also clear that blood specimens were being reused,” Dr. Stadelman-Behar said. “We found vials with no label, no date of birth, no date of collection, that had been punctured multiple times.”
She advised people who receive these kinds of cosmetic procedures to ask providers to open syringes and vials in front of them, and to make sure that when their blood is drawn, the vials are properly labeled with their name, date of birth and date of collection.
“But the biggest takeaway is that licensing is super important,” she said.